Provider Demographics
NPI:1679727457
Name:VICKERS, JOSHUA ADAM (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ADAM
Last Name:VICKERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 W 120TH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2979
Mailing Address - Country:US
Mailing Address - Phone:303-465-6332
Mailing Address - Fax:303-465-6349
Practice Address - Street 1:2751 W 120TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2979
Practice Address - Country:US
Practice Address - Phone:303-465-6332
Practice Address - Fax:303-465-6349
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6278111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO84-2734812OtherIRS